If you're over 30 your chances for developing periodontal (gum) disease are better than half. And it's not a minor matter—untreated gum disease can lead not only to tooth loss, but to an increased risk of cardiovascular disease and other inflammatory conditions.
Fortunately, we have effective ways to treat gum disease, even in advanced stages. But the best approach by far in avoiding a devastating outcome for your teeth is to prevent gum disease from developing in the first place.
It helps first to know how gum disease begins. The most common cause is dental plaque, a thin biofilm of food particles on tooth surfaces that harbors the bacteria that triggers the disease. If you keep your teeth clean of built-up plaque and tartar (calcified plaque) with daily brushing and flossing and regular dental cleanings, you'll minimize the growth of disease-causing bacteria.
If you don't practice effective oral hygiene, however, within a few days you could develop an initial infection called gingivitis. This form affects the outermost layers of the gums and triggers a defensive response from the body known as inflammation. Ordinarily, inflammation helps protect surrounding tissues from infection spread, but it can damage your gums if it becomes chronic. Your weakened gums may begin to detach from the teeth, forming voids filled with inflammation known as periodontal pockets. Eventually, the infection can spread to the supporting bone and lead to tooth loss.
In addition to a dedicated oral hygiene and dental care program, you should also be on the lookout for early signs of gingivitis. Infected gums can become red, swollen and tender to the touch. You may notice they bleed easily while brushing and flossing, or a foul taste or breath that won't go away even after brushing. And if some of your teeth feel loose or don't seem to bite together as they used to, this is a sign of advanced gum disease that deserves your dentist's immediate attention.
Practicing preventive hygiene is the best way to stop gum disease before it starts. But if gum disease does happen, catching it early can be a game-changer, both for your teeth and your smile.
If you would like more information on preventing and treating gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
Wearing orthodontic braces brings challenges to daily life. During treatment a patient will need to avoid certain foods and habits, take more time to brush and floss properly, and may endure occasional discomfort. But the effect of metal braces on appearance can be especially difficult, especially for peer-conscious teens.
Clear aligners, though, offer an alternative to braces that could make some of these challenges easier, particularly with your appearance. Aligners are clear plastic trays that fit over the teeth to move them. They can be removed by the wearer for easier brushing and flossing or for special occasions. Best of all, they're much less noticeable than metal braces.
Clear aligners were developed thanks to advances in digital technology. An orthodontist uses a computer application incorporating the data from photographs, x-rays or CT scans of a patient's teeth and jaws to produce a series of clear plastic trays. The patient then wears each tray for about two weeks before changing to the next tray in the sequence.
The trays apply pressure much like metal braces to gradually move teeth to the desired position on the jaw. Each tray is slightly smaller in size than the previous tray in the sequence, so that the progression of tooth movement continues with each succeeding tray. The treatment time is about the same as with conventional braces.
This new orthodontic tool works well for many common bite problems, but until recently they've been limited in scope. But new designs in trays and attachments called buttons added to teeth to provide more leverage have greatly increased their use for more complex bite issues.
Clear aligners also have one other disadvantage, ironically due to one of their principal benefits, removability. Although they can be taken out, they must be worn consistently to achieve results. Some younger patients may not have the maturity level and discipline to responsibly wear their aligners as they should.
That's one issue you'll need to discuss with your orthodontist if you're considering clear aligners for your teen. But if they can maintain wearing consistency, and they have a bite problem that can be corrected with aligners, both you and your teen may find this choice more agreeable and attractive than braces.
If you would like more information on clear aligners, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Clear Aligners for Teens.”
At this time of year, hearts are everywhere you look, so it's fitting that February is American Heart Month, a time to focus on cardiovascular health. Cardiovascular disease, which includes heart disease and stroke, is the number one cause of death around the world. But did you know that there's a link between the health of your heart and the health of your mouth?
People with advanced gum disease have a higher risk of having a heart attack, stroke or other cardiovascular event, but what is the connection? For one, oral bacteria found in gum disease can enter the bloodstream, where it has been found in artery-clogging plaque. In addition, untreated gum disease has been determined to worsen high blood pressure, a major contributor to heart attack, stroke and heart failure. One study reported that when gum disease was treated, high blood pressure fell by up to 13 points. But perhaps the most significant common denominator between gum disease and heart disease is inflammation, according to many researchers.
Gum disease is the most common inflammatory disease, affecting nearly 50% of US adults over 30, and 70% of those aged 65 and older, according to the U.S. Centers for Disease Control. The body's inflammation response is a key weapon in fighting infection. However, when there is chronic low-level inflammation such as occurs with untreated periodontal (gum) disease, many adverse health effects can result. In one Harvard University study, chronic inflammation was found to triple the risk of heart attack and double the risk of stroke.
The relationship between gum disease and heart disease is still not completely understood, but there's no denying that a connection exists between the two, so it's worth doing what you can to take care of both your gums and your cardiovascular health. Here are some tips:
- Eat a heart-healthy—and gum-healthy—diet. A diet low in refined carbohydrates, high in fiber, vitamins C and D, antioxidants and Omega-3s has been shown to lower inflammation, benefitting your gums and your heart.
- Quit smoking. Using tobacco in any form is a risk factor for developing both gum disease and heart disease.
- Take care of your oral health. Gum disease can often be prevented—and reversed if caught early—simply with good oral hygiene, so be diligent about brushing your teeth twice a day and flossing once a day.
- Come in for regular cleanings and checkups. Regular cleanings can help keep your gums healthy, and an examination can determine if you have gum disease. Be sure to tell us about any medical conditions or medications.
As you think about what you can do to take care of your heart health and overall health, don't forget your gums. If you have questions about how to improve your oral health, call us or schedule a consultation. You can learn more in the Dear Doctor magazine articles “Good Oral Health Leads to Better Health Overall” and “Carbohydrates Linked to Gum Disease.”
A root canal treatment is a common procedure performed by dentists and endodontists (specialists for inner tooth problems). If you're about to undergo this tooth-saving procedure, here's what you need to know.
The goal of a root canal treatment is to stop tooth decay within a tooth's interior and minimize any damage to the tooth and underlying bone. This is done by accessing the tooth's pulp and root canals (tiny passageways traveling through the tooth roots to the bone) by drilling into the biting surface of a back tooth or the "tongue" side of a front tooth.
First, though, we numb the tooth and surrounding area with local anesthesia so you won't feel any pain during the procedure. We'll also place a small sheet of vinyl or rubber called a dental dam that isolates the affected tooth from other teeth to minimize the spread of infection.
After gaining access inside the tooth we use special instruments to remove all of the diseased tissue, often with the help of a dental microscope to view the interior of tiny root canals. Once the pulp and root canals have been cleared, we'll flush the empty spaces with an antibacterial solution.
After any required reshaping, we'll fill the pulp chamber and root canals with a special filling called gutta-percha. This rubberlike, biocompatible substance conforms easily to the shape of these inner tooth structures. The filling preserves the tooth from future infection, with the added protection of adhesive cement to seal it in.
Afterward, you may have a few days of soreness that's often manageable with mild pain relievers. You'll return for a follow-up visit and possibly a more permanent filling for the access hole. It's also likely you'll receive a permanent crown for the tooth to restore it and further protect it from future fracture.
Without this vital treatment, you could very well lose your tooth to the ravages of decay. The time and any minor discomfort you may experience are well worth the outcome.
If you would like more information on treating tooth decay, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Root Canal Treatment: What You Need to Know.”
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